Do Electronic Cigarettes Actually Work?

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There are all sorts of products out on the market made to wean smokers off a dangerous habit—the patch, the lozenge, and the gum, for example. Yet, what about the e-cigarette?

Though it’s marketed as a “safer” alternative to cigarettes, and not necessarily a smoking-cessation device, unlike the other nicotine delivery products, e-cigarettes—battery-operated devices that supposedly work by heating up a liquid nicotine substance which “e-smokers” inhale as vapor—aren’t regulated by the Food and Drug Administration (FDA).

In fact, according to the American Medical Association, on January 14, a federal judge ruled that e-cigarettes should not be subject to FDA regulation because they are merely an alternative to traditional cigarettes, which are readily available. Medical experts counter that, though they may be marketed as alternatives to traditional cigarettes, people are turning to them as a smoking cessation product, which means that greater oversight is critical.

In the midst of this heated debate, however, a researcher from the Institute for Drug and Alcohol Studies at Virginia Commonwealth University decided to put two brands of e-cigarettes to the test, to see just how they stack up against actual cigarettes. His findings, published in the February issue of the journal Tobacco Control, suggest that the e-smokes fail to deliver much nicotine, or help reduce cravings.

The study, led by psychologist Thomas Eissenberg, included 16 smokers. In four different phases of the study, each separated by two days, they were asked to: smoke a cigarette from their preferred brand; “sham smoke” a cigarette—or basically “puff” on it without lighting it; use an Njoy NPRO electronic cigarette filled with a 16mg nicotine cartridge; and use a Crown 7 Hydro e-cigarette filled with a 16mg nicotine cartridge. Both e-cigarettes’ batteries were fully charged for each “smoking” session.

Prior to the trials, smokers were asked to abstain from nicotine for 12 hours. At the beginning of each session, they had catheters inserted into their veins, enabling researchers to take blood samples multiple times—5, 15, 30 and 45 minutes after the first puff—to measure for nicotine content. They found that, as you would expect, actually smoking dramatically increased nicotine content in the blood. Yet, when it came to the e-cigarettes, both brands increased nicotine content only nominally more than sham smoking. What’s more, the products did little to reduce cigarette cravings.

In light of the findings, Eissenberg argues for more thorough testing and regulation of the products, as well as a greater awareness of potential health risks of misuse. As he points out, for example, the refill liquid for e-cigarettes, which is meant to be added by the drop, is sold in bottles containing some 500mg of nicotine, or 10 times the lethal dose. As Eissenberg concludes:

“[T]he results reported here all support the notion that electronic nicotine delivery devices (E- cigarettes) and their nicotine-containing solution should be evaluated, regulated, labeled and packaged in a manner consistent with cartridge content and product effect. At the least, consumers should be aware that, unlike several regulated nicotine products (eg, gum,patch), these putative drug delivery systems do not deliver nicotine effectively after acute administration.”

Eissenberg’s findings add to earlier concerns from the FDA, the World Health Organization, and other health organizations that have questioned the safety of the faux cigarettes and urged potential users to “exercise caution.”

So, what’s the bottom line? If you’re looking for a safer alternative to cigarettes, it’s hard to oversell the health benefits of kicking the habit. And if you’re looking for products to help you quit smoking, it’s best to look elsewhere.